乌司他丁对术中单肺通气患者的肺保护作用  

Protective effects of ulinastatin on pulmonary tissue of patients with unilateral ventilation during operation

作　　者：刘秀珍[1] 王卓强[1] 魏昌伟[1] 徐震[1] 陈绪贵[1] 张斌[1] 王恒林[1] 

机构地区：[1]解放军总医院第二附属医院麻醉科,北京100091

出　　处：《解放军医学杂志》2009年第7期894-895,共2页Medical Journal of Chinese People's Liberation Army

摘　　要：目的通过观察单肺通气患者术中氧合指数(OI)、呼吸指数(RI)及动态肺顺应性(Cdyn)的变化,探讨乌司他丁对术中单肺通气患者的肺保护作用。方法选择行单肺叶切除、术中需单肺通气的肺癌患者(ASAⅡ-Ⅲ级)50例,年龄36～60岁,体重52～74kg,其中男25例、女25例。随机分为对照组(C组)和乌司他丁组(U组),各25例。分别监测并记录两组患者切皮前(T1)、单肺通气30min(T2)、单肺通气60min(T3)、双肺通气60min(T4)各时段的OI、RI及Cdyn变化。结果两组患者OI、RI及Cdyn在T1时段无显著性差异(P>0.05);U组患者在T2、T3及T4时段的OI和Cdyn较C组明显升高,RI明显降低(P<0.05);且U组患者在T4时段的OI和Cdyn较T1时段明显增高,RI明显降低(P<0.05)。结论乌司他丁能够改善术中单肺通气患者的OI、RI及Cdyn,对其肺功能有一定的保护作用。Objective To explore the protective effects of ulinastatin on the pulmonary tissue of patients with unilateral ventilation during operation by observing the changes in oxygenation index （OI）, respiratory index （RI） and dynamic lung compliance （Cdyn）. Methods Fifty patients with pulmonary carcinoma （in ASA Ⅱ-Ⅲ grade）, undergoing unilateral pulmonary lobeetomy with unilateral pulmonary ventilation, were randomly divided into control group （group C, n=25） and experimental group （group U, n=25）. Patients in group U received ulinastatin along with pulmonary ventilation during operation, while the control group received normal saline. Blood sampies were taken before operation （T1）, and at the time points of 30 and 60 min after unilateral lung ventilation （T2 and T3） and 60 rain of bilateral lung ventilation （T4）, respectively. The OI, RI and Cdyn were calculated and compared between the two groups. Results No statistically significant difference was found in OI, RI and Cdyn in the two groups at T1. The OI and Cdyn were higher, and the RI was lower at T2, T3 and T4 in group U than in group C （P〈0. 05）. In group U, the OI and Cdyn were higher and the RI was lower at T4 than at T1. Conclusion Ulinzstatin can play a protective role in patients with unilateral pulmonary ventilation by improving OI, RI and Cdyn during operation.

关 键 词：乌司他丁 肺通气 肺顺应性 

分 类 号：R614[医药卫生—麻醉学]